Tuesday, September 1, 2009

The ED world is buzzing with the same chat that always goes on in August: parents and clinicians looking for referrals to eating disorder treatment for a student leaving for college. These emails, listing symptoms and medical state, break my heart. They often use the word "motivated" and "charming" as if patients need to be pleasing in order to garner a clinician's attention.

It all begs the question: Why would a student with an active eating disorder be going to college? Really - I'm serious. I don't understand why this is acceptable. This is a life-sucking, potentially disabling or lethal illness: an anosognosic condition that thrives on secrecy and freedom from monitoring.

I know the tremendous pressure on parents by social expectations, by the young person's insistence that everything will be all right and that this is all he or she "lives for." I know the guilt and disempowerment of being told by professional advisers that we must 'let go.' I also know parents just get tired, and our egos get involved in the accomplishments of our children.But you know what? We're parents, and that is a lifelong position. We have a right and a responsibility to do what is right for our child according to our unique and loving judgement. No one can tell us (and no one will take responsibility later) whether college is safe or advisable.I put my money where my mouth is on this one: my daughter relapsed slightly after her freshman year and we withdrew support for college until she was not just well but quite well. She did not like that. We did not like doing it. But I believe it was our job to do it, and her longterm health and recovery depended on it. When she was ready, she went back and thrived (and had a treatment team for maintenance).

I've dealt with two universities as a parent - neither were in a position to protect or support my daughter's mental health. They said they could and would, but that isn't realistic. Looking back I don't know why I entertained the idea that they could. This is not diabetes or a vision problem where the patient is motivated and able to reliably self-monitor. Schools are not parents.

No team of providers on or off campus is going to be able to provide the kind of accountability and monitoring and personal support that a parent provides and an eating disorder patient deserves. No one at the dorm is going to watch out for or call the parents of a student unless the situation is so far gone that irreparable damage is done. We can't expect it and we can't get angry that they don't do it.

If you are not 100% confident of your child's recovery, committed to staying in the picture more than your child and school may like, ready to visit frequently, and have an expert team in place and in communication then why is college more important? If you feel pressured, or exhausted, or trapped, keep this in mind:

During November break is when I get the most emails and calls - from families who now realize their hand-wringing worries were well-founded and a shaky recovery is now an derailing relapse.